heroin. The 2016 figures not yet released is expected to rise considerably and make up an even more significant percentage of overall drug overdoses.
Since 1999, when opioids started to ravage communities, 183,000 Americans have died from overdoses related to prescription opioids.
While the U.S. has witnessed waves of drug epidemics in the past, the opioids crisis is far deadlier because of the sheer potency of this class of drugs. Popular street drugs such as cocaine and crystal methamphetamine (once a crisis in Hawaii in the early 2000s) are less likely to result in overdose than natural and semisynthetic opioids. The U.S. Drug Enforcement Administration reports the most powerful synthetic opioid, carefentanil, is so dangerous that accidentally inhaling just a small amount in the air or absorbing it through the skin can be toxic and fatal. Carefentanil, known as an elephant tranquilizer, is 5,000 times stronger than heroin.
Dr. Tom Friedman, head of the CDC, said of opioids “We know of no other medication routinely used for nonfatal condition that kills patients so frequently.”
While overdoses are a major problem, what makes the opioid epidemic of greater concern is the addiction rate. Opioids interacts with receptors in the brain and nervous system to produce highly pleasurable effects and relieve pain. This unusually powerful high keeps addicts hooked on opioids.
The CDC estimates that over two million Americans are addicted to opioids, and an additional 95 million used prescription painkillers in the past year that could make them vulnerable to addiction. Studies show that it’s possible to become addicted after just one course of opioid treatment.
From a cost standpoint, federal officials estimate the opioid crisis drains nearly $80 billion a year from the U.S. economy with expenses to health care, criminal justice, and lost productivity. An additional $36 billion a year is spent on addiction treatment.
Close to 1.3 million hospital emergency visits or inpatient visits have been linked to opioids in 2014. Emergency room visits for opioid incidences nearly doubled in the last decade.
Opioid addiction has also been linked to a myriad of social problems: divorce, child neglect and abuse, job loss, prostitution and homelessness.
Road to Addiction
While each opioid addict has a unique story, the pattern of addiction usually starts with an injury of some kind that results in chronic pain and requires a doctor to prescribe narcotic pain killers. In the late 1990s, pharmaceutical companies underplayed the addictive nature of opioid pain relievers through misleading advertisements and healthcare providers began to prescribe them at greater rates.
After some time using prescription opioids, some patients would become addicted to them. Between 8 to 12 percent of prescription users develop an opioid use disorder. The physician eventually stops prescribing opioids. But some patients make a dangerous transition into black market, street heroin as a substitute. It’s estimated 4 to 6 percent who misuse prescription opioids transition to heroin. About 80 percent of people who use heroin report starting with prescription opioids. Opioids are known as the gateway to heroin.
In the last stage of addiction when street heroin is the drug of choice, either the addict hits rock bottom and breaks the habit through a series of rehabilitation visits or falls deeper in a spiral of addiction that sometimes end in death.
The opioid drug problem is both a prescription and street drug problem that is one reason it has mushroomed into the large-scale public health crisis of today. The opioid crisis has no clear face. It afflicts the poor, middle class, professionals, urbanites, suburban families, old, middle-aged and youth. One group overrepresented in opioid addiction rate is veterans. The VA reports 68,000 veterans are afflicted with opioid disorders. That figure represents about 13 percent of all veterans currently taking opioids. In 2013, a study showed veterans fatally overdosed on prescription opioid at a rate twice the national average.
Beating the Opioid Epidemic
Experts believe controlling the opioid crisis will take a coordinated effort from government, physicians, the pharmaceutical industry; and on the enforcement end, politicians and the police force.
The U.S. Congress passed a bipartisan bill, the Comprehensive Addiction and Recovery Act of 2016, that authorized grants to help states deal with the opioid epidemic. The bill, signed into law in July 2016, establishes programs for veterans impacted by opioids, among other initiatives. Most federal government efforts on opioids are focused on treatment and education awareness campaigns.
Before lawmakers and healthcare professionals can begin a serious war against opioid addiction, experts believe the community first must rise against it as what occurred with the ice epidemic. Hawaii used to be number one in meth addiction with a whopping 410 percent above the national average. It now paces behind several midwestern states where drug trafficking from meth super labs in Mexico is easier to transport. Tougher laws and enforcement have been proven to work in dampening crystal meth addiction and government officials want to replicate that success on the war against opioids.
At the peak of Hawaii’s crystal methamphetamine or “ice” in the early 2000s, millions of dollars were poured into drug busts and treatment. Town hall meetings, “ice” summits and an effective anti-ice campaign was launched. In addition to funding close to 15 million, Hawaii lawmakers also crafted a law that required the monitoring of over-the counter sale of ephedrine and pseudoephedrine found in cold remedies. Drug dealers used these ingredients to cook homemade meth. This law tracking cold medicine has helped to significantly retard local meth labs.
Opioid Misuse in Hawaii
Hawaii has been spared from the full brunt of the opioid crisis relative to the East Coast and Midwestern U.S. states. The National Center for Health Statistics reported that in 2015 alone there have been 169 deaths related to opioid use in Hawaii. But that number is still high considering there have been 86 car fatalities in Hawaii in the same year.
Close to 300 addicts have checked into Hawaii drug rehabilitation centers for opioid addiction. Hilo and Honolulu have the highest rates of opioid misuse. But experts believe there are much more under-the-radar cases of addicts trying to beat their opioid addiction secretly.